Pub Date : 2020-09-23DOI: 10.21203/rs.3.rs-79504/v1
Y. Qian, Zhi-tao Yu, Zhenlei Liu, W. Duan, Zhongjing Zhao, Hongyu Zheng, F. Jian
Background: There is still no consensus on the time period of wearing collar after anterior cervical discectomy and fusion (ACDF). We aim to investigate the optimal time period of wearing protective collar.Methods: We retrospectively reviewed patients with cervical spondylosis who underwent one to two segment ACDF during January 2016 and December 2017, and included 97 patients who meet inclusion and exclusion criterion. Patients were divided into three groups according to the actual time period of wearing collar after ACDF including 1-4 week group, 5-8 week group, and 9-12 week group. We analyzed Japanese Orthopedic Association (JOA) score, Axial Symptom (AS) score and Neck Disability Index (NDI) before surgery and at post-operative 3 months to investigate the optimal time period of wearing collar.Results: JOA score: All three groups have a better post-operative JOA score compared with that before surgery (paired t test, p<0.05). There is no significant difference among the three groups with respect to post-operative JOA (ANOVA, p>0.05).AS score: The post-operative AS scores of 1-4 week group and 5-8 week group were significantly better than that before surgery (paired t test, p>0.05). While the post-operative AS score of 9-12 week group was significantly worse than preoperative AS score (paired t test, p<0.05).NDI: All three groups have a better post-operative NDI compared with that before surgery (McNemar test, p<0.05). Of note, in 5-8 week group, the percentage of no deficit increased by 45%, and the percentage of mild deficit decreased by 45% accordingly. That percentage is 26% and 31% in 1-4 week group and 9-12 week group, respectively. There was significant difference among these three groups (Fisher's exact probability test, p<0.05)Conclusions: For cervical spondylosis patients who underwent 1-2 segment ACDF, the optimal time period of wearing protective is 5-8 weeks. This time period results in comparable neurological outcome, least axial symptom risk, and highest chance of no deficit on neck function.
{"title":"Optimal Time Period of Wearing Protective Collar After Anterior Cervical Discectomy and Fusion","authors":"Y. Qian, Zhi-tao Yu, Zhenlei Liu, W. Duan, Zhongjing Zhao, Hongyu Zheng, F. Jian","doi":"10.21203/rs.3.rs-79504/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-79504/v1","url":null,"abstract":"\u0000 Background: There is still no consensus on the time period of wearing collar after anterior cervical discectomy and fusion (ACDF). We aim to investigate the optimal time period of wearing protective collar.Methods: We retrospectively reviewed patients with cervical spondylosis who underwent one to two segment ACDF during January 2016 and December 2017, and included 97 patients who meet inclusion and exclusion criterion. Patients were divided into three groups according to the actual time period of wearing collar after ACDF including 1-4 week group, 5-8 week group, and 9-12 week group. We analyzed Japanese Orthopedic Association (JOA) score, Axial Symptom (AS) score and Neck Disability Index (NDI) before surgery and at post-operative 3 months to investigate the optimal time period of wearing collar.Results: JOA score: All three groups have a better post-operative JOA score compared with that before surgery (paired t test, p<0.05). There is no significant difference among the three groups with respect to post-operative JOA (ANOVA, p>0.05).AS score: The post-operative AS scores of 1-4 week group and 5-8 week group were significantly better than that before surgery (paired t test, p>0.05). While the post-operative AS score of 9-12 week group was significantly worse than preoperative AS score (paired t test, p<0.05).NDI: All three groups have a better post-operative NDI compared with that before surgery (McNemar test, p<0.05). Of note, in 5-8 week group, the percentage of no deficit increased by 45%, and the percentage of mild deficit decreased by 45% accordingly. That percentage is 26% and 31% in 1-4 week group and 9-12 week group, respectively. There was significant difference among these three groups (Fisher's exact probability test, p<0.05)Conclusions: For cervical spondylosis patients who underwent 1-2 segment ACDF, the optimal time period of wearing protective is 5-8 weeks. This time period results in comparable neurological outcome, least axial symptom risk, and highest chance of no deficit on neck function.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48276959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.37421/2165-7920.2020.10.1344
S. Basha, Bashayer S Helaby, Manar H. Alhefdhi
Background: Extra teeth number in the patient’s mouth is scientifically known as supernumerary teeth. Multiple supernumerary teeth are frequently seen in patients with developmental disorders. Cone-Beam Computed Tomography (CBCT) is a three-dimensional imaging tool that can provide a precise case planning. The purpose of this paper is to present a rare case of double parapremolars in on single quadrant and investigate these teeth by using Cone-Beam Computed Tomography (CBCT). Case Description: A 28-year-old, Filipino female patient came to PNU dental clinics. She was medically fit, not on medications and no allergies were detected. Intraoral examination revealed presence of two supernumerary teeth at the area between #35 and #36. The Parapremolars located in quadrant three, both are with normal shape and color. Regarding the position, the first supernumerary has erupted lingually, the second is in the arch line but slightly tilted to the lingually. As a result of the extra teeth number, moderate crowding found in the area. The patient denied any family history of similar findings. Discussion: Extraction of the first supernumerary tooth was carried out after radiographic analysis using CBCT, to facilitate proper oral hygiene, to prevent food impaction, and to eliminate its possible effects on the adjacent teeth. Extraction was performed cautiously without causing any damage to the anatomical structures. Regarding the anatomical position of the tooth, we prepared splint for teeth stabilization in case of adjacent teeth mobility. Extraction was done under local anesthesia. The patient was followed up after the extraction, no complications were reported. Conclusion: Double parapremolar teeth were found in a non-syndromic patient. CBCT precisely locate malposed supernumerary teeth and help in getting proper treatment plan without complications.
{"title":"An Unusual Case of Double Mandibular Parapremolars: A Cone Beam Computed Tomography Assessed Case Report","authors":"S. Basha, Bashayer S Helaby, Manar H. Alhefdhi","doi":"10.37421/2165-7920.2020.10.1344","DOIUrl":"https://doi.org/10.37421/2165-7920.2020.10.1344","url":null,"abstract":"Background: Extra teeth number in the patient’s mouth is scientifically known as supernumerary teeth. Multiple supernumerary teeth are frequently seen in patients with developmental disorders. Cone-Beam Computed Tomography (CBCT) is a three-dimensional imaging tool that can provide a precise case planning. The purpose of this paper is to present a rare case of double parapremolars in on single quadrant and investigate these teeth by using Cone-Beam Computed Tomography (CBCT). Case Description: A 28-year-old, Filipino female patient came to PNU dental clinics. She was medically fit, not on medications and no allergies were detected. Intraoral examination revealed presence of two supernumerary teeth at the area between #35 and #36. The Parapremolars located in quadrant three, both are with normal shape and color. Regarding the position, the first supernumerary has erupted lingually, the second is in the arch line but slightly tilted to the lingually. As a result of the extra teeth number, moderate crowding found in the area. The patient denied any family history of similar findings. Discussion: Extraction of the first supernumerary tooth was carried out after radiographic analysis using CBCT, to facilitate proper oral hygiene, to prevent food impaction, and to eliminate its possible effects on the adjacent teeth. Extraction was performed cautiously without causing any damage to the anatomical structures. Regarding the anatomical position of the tooth, we prepared splint for teeth stabilization in case of adjacent teeth mobility. Extraction was done under local anesthesia. The patient was followed up after the extraction, no complications were reported. Conclusion: Double parapremolar teeth were found in a non-syndromic patient. CBCT precisely locate malposed supernumerary teeth and help in getting proper treatment plan without complications.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"10 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70048236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-19DOI: 10.4172/2165-7920.10001222
A. Fawwaz, H. Mutaz., Abdullah Maen
Objective: To evaluate macular vascular circulation in patient with perifoveal vasculitis secondary to Behcet’sdisease by using (Retinal Flow) swept source optical coherence tomography angiography map.Case report: We retrospectively review a 39-year-old female patient, with history of Behcet’s disease, presented with history of sudden unexplained central loss of vision which was more significant on the right eye with best corrected vision (BCVA=0.1) and less on the left eye with best corrected visual acuity (BCVA=0.7). The clinical ophthalmic examination of both anterior and posterior segments for the both eyes were normal with no any signs of uveitis. Imaging with DRI Triton Swept Source (SS- OCTA) (Topcon, Japan) was performed for evaluation of both superficial and deep capillary plexus of macular area. Fluorescein angiography (FA) was used also for assessing foveal avascular zone features.Results: The SS-OCTA Retinal Flow map was more sensitive than FA in marking out hypoperfusion in both superficial capillary plexus (SCP), and deep capillary plexus (DCP), especially in the right eye which had the positive correlation with visual acuity. SS-OCTA Retinal Flow map was also sensitive in showing improvement of macular hypoperfusion after treatment of Behcet’s Perifoveal Vasculitis.Conclusion: OCTA is a noninvasive imaging modality that can be used to evaluate macular vascular changes in Bechet’s perifoveal vasculitis and can explain acute visual loss in Behcet.
{"title":"Evaluation of Macular Circulation in Patient with Sudden Visual Loss Secondary to Behcet's Perifoveal Vasculitis by using (Retinal Flow) Swept-Source Optical Coherence Tomography Angiography Map","authors":"A. Fawwaz, H. Mutaz., Abdullah Maen","doi":"10.4172/2165-7920.10001222","DOIUrl":"https://doi.org/10.4172/2165-7920.10001222","url":null,"abstract":"Objective: To evaluate macular vascular circulation in patient with perifoveal vasculitis secondary to Behcet’sdisease by using (Retinal Flow) swept source optical coherence tomography angiography map.Case report: We retrospectively review a 39-year-old female patient, with history of Behcet’s disease, presented with history of sudden unexplained central loss of vision which was more significant on the right eye with best corrected vision (BCVA=0.1) and less on the left eye with best corrected visual acuity (BCVA=0.7). The clinical ophthalmic examination of both anterior and posterior segments for the both eyes were normal with no any signs of uveitis. Imaging with DRI Triton Swept Source (SS- OCTA) (Topcon, Japan) was performed for evaluation of both superficial and deep capillary plexus of macular area. Fluorescein angiography (FA) was used also for assessing foveal avascular zone features.Results: The SS-OCTA Retinal Flow map was more sensitive than FA in marking out hypoperfusion in both superficial capillary plexus (SCP), and deep capillary plexus (DCP), especially in the right eye which had the positive correlation with visual acuity. SS-OCTA Retinal Flow map was also sensitive in showing improvement of macular hypoperfusion after treatment of Behcet’s Perifoveal Vasculitis.Conclusion: OCTA is a noninvasive imaging modality that can be used to evaluate macular vascular changes in Bechet’s perifoveal vasculitis and can explain acute visual loss in Behcet.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44254244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-22DOI: 10.4172/2165-7920-C3-024
P. K. Liebenberg, Adrian Cohenp
{"title":"A rare case of small bowel obstruction following colonoscopy","authors":"P. K. Liebenberg, Adrian Cohenp","doi":"10.4172/2165-7920-C3-024","DOIUrl":"https://doi.org/10.4172/2165-7920-C3-024","url":null,"abstract":"","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70752955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-22DOI: 10.4172/2165-7920-C3-023
pApinhapanit Rittigornp
{"title":"Hodgkins lymphoma presented with endotracheal and endobronchial mass: A rare case report","authors":"pApinhapanit Rittigornp","doi":"10.4172/2165-7920-C3-023","DOIUrl":"https://doi.org/10.4172/2165-7920-C3-023","url":null,"abstract":"","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70752787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N V Baclig, C Ngo, A C Yeh, S H Chung, A Cheng, J Grim, S A Graf, K C Yang
While immune checkpoint inhibitors (ICIs) are improving outcomes for many cancers, they can have severe adverse effects. Though cardiac immune-related adverse effects (irAEs) are rare, they have considerable morbidity and mortality. Prior case studies have demonstrated successful treatment of ICI induced autoimmune myocarditis with a variety of immunosuppressive regimens. This case describes steroid-refractory autoimmune myocarditis after treatment with pembrolizumab. Treatment with equine anti-thymocyte globulin, a regimen previously documented to reverse ICI induced autoimmune myocarditis, temporarily improved clinical status and cardiac biomarkers, however eventually failed to prevent progression to heart failure and cardiovascular death. This case highlights the importance of early stress-dose steroids, identifies troponin as a potential marker of treatment response, and underscores the value of collaboration between oncology and cardiology for optimal management.
{"title":"Steroid-Refractory Autoimmune Myocarditis after Pembrolizumab Therapy: Failure of Equine Anti-Thymocyte Globulin to Prevent Heart Failure.","authors":"N V Baclig, C Ngo, A C Yeh, S H Chung, A Cheng, J Grim, S A Graf, K C Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>While immune checkpoint inhibitors (ICIs) are improving outcomes for many cancers, they can have severe adverse effects. Though cardiac immune-related adverse effects (irAEs) are rare, they have considerable morbidity and mortality. Prior case studies have demonstrated successful treatment of ICI induced autoimmune myocarditis with a variety of immunosuppressive regimens. This case describes steroid-refractory autoimmune myocarditis after treatment with pembrolizumab. Treatment with equine anti-thymocyte globulin, a regimen previously documented to reverse ICI induced autoimmune myocarditis, temporarily improved clinical status and cardiac biomarkers, however eventually failed to prevent progression to heart failure and cardiovascular death. This case highlights the importance of early stress-dose steroids, identifies troponin as a potential marker of treatment response, and underscores the value of collaboration between oncology and cardiology for optimal management.</p>","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"2 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9142919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7920.10001201
Alonazi Na, S. Mohamed, A. Alonazi, H. Elshazaly, B. Jóri, M. Alanazi, Hashem Aa
Immunodeficiency, centromeric instability, and facial dysmorphism (ICF) syndrome is a rare autosomal recessive disorder, characterized by a variable reduction in serum immunoglobulins, sometimes combined with defective cellular immunity. Here, we report an 18-month-old boy, who presented with colonic perforation. The molecular diagnosis was confirmed by whole-exome sequencing that revealed a homozygous c.2506G>A, (p.Val836Met) mutation in DNMT3B gene. This report expands the clinical and immunological features of ICF syndrome.
{"title":"Immunodeficiency, Centromeric Instability and Facial Dysmorphism Syndrome: A Case Report","authors":"Alonazi Na, S. Mohamed, A. Alonazi, H. Elshazaly, B. Jóri, M. Alanazi, Hashem Aa","doi":"10.4172/2165-7920.10001201","DOIUrl":"https://doi.org/10.4172/2165-7920.10001201","url":null,"abstract":"Immunodeficiency, centromeric instability, and facial dysmorphism (ICF) syndrome is a rare autosomal recessive disorder, characterized by a variable reduction in serum immunoglobulins, sometimes combined with defective cellular immunity. Here, we report an 18-month-old boy, who presented with colonic perforation. The molecular diagnosis was confirmed by whole-exome sequencing that revealed a homozygous c.2506G>A, (p.Val836Met) mutation in DNMT3B gene. This report expands the clinical and immunological features of ICF syndrome.","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70706214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7920.10001225
A. A
{"title":"Factors and Clinical Scenarios Possibly Related to Endometrial Micropolyps and Chronic Endometritis","authors":"A. A","doi":"10.4172/2165-7920.10001225","DOIUrl":"https://doi.org/10.4172/2165-7920.10001225","url":null,"abstract":"","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001225","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70708308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.4172/2165-7920.10001221
Wiesław B, Lasek-Bal A
{"title":"The Radiological Image of the Spread Gastric Cancer to the Nervous System in Patient with Presence of HER-2 Overexpression","authors":"Wiesław B, Lasek-Bal A","doi":"10.4172/2165-7920.10001221","DOIUrl":"https://doi.org/10.4172/2165-7920.10001221","url":null,"abstract":"","PeriodicalId":73664,"journal":{"name":"Journal of clinical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2165-7920.10001221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70708473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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